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Mutism is a speech disorder consisting in the lack or limitation of the use of one’s own speech while understanding others. The diagnosis of mutism is within the competence of a speech therapist, psychologist and psychiatrist. Mutism can occur in both children and adults. Rapid diagnosis and treatment implementation is important because treatment is most effective before mutism disorders become permanent.
Types of mutism
Total mutism
Complete mutism is a disorder in which a child is completely speechless. The child may make inarticulate sounds or scream. The child understands others and can answer questions or react to others with gestures, e.g. by nodding his head.
Complete mutism may be accompanied by swallowing disorders or eating disorders.
Situational mutism
Situational mutism consists in the presence of limitation or lack of speech in specific situational contexts, e.g. when a child is in a stressful, difficult situation, does not feel well / safe. The child then communicates by means of gestures or facial expressions.
Most often it appears periodically during adaptation to kindergarten or school. The disorder passes when the child gets used to a new, previously stressful situation in life, e.g. when he gets used to kindergarten, he starts communicating again through speech.
Selective mutism
Selective mutism, otherwise known as selective mutism, occurs when a child communicates through speech in a selective manner. He chooses the people with whom he talks, and he is absolutely silent towards other people.
In the case of a confrontation with a person who has been excluded by a child, he or she may react with dejection (standing still, not making eye contact, showing no emotions) or emotional outbursts (aggression, running away, crying).
Children with selective mutism most often admit their closest relatives to the circle of interlocutors, but exclude other, “strangers” adults. This mainly concerns the exclusion of adults from the child’s environment at school or kindergarten.
Treatment of mutism
Treatment of mutism occurs in two ways:
* a method of behavioral therapy aimed at assimilating new behaviors and eliminating existing, harmful and established patterns of behavior;
* method of psychodynamic therapy – aimed at reaching the hidden, subconscious causes of the patient’s problems.
In addition to the most common psychological mutism, akinetic mutism can occur.
Akinetic mutism
Akinetic mutism, also known as the apalic state, is caused by damage to the nervous system. Its immediate cause may be an accident or illness. The sick person is conscious and can move his eyes around, open and close them, but he has no control over speech and body movements. Reflexes from outside the autonomic system responsible for vital functions of internal organs are suppressed, i.e. reflexes dependent on the patient’s will.
The patient is able to akinesis, i.e. it cannot make contact with the environment in any way.
Akinetic mutism can occur as a result of stroke, hypoxia or cancer. It also appears in the last stage of Creutzfeldt-Jakob disease.
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